Kimberley M Johnson DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3423 Issued in MN

Legal business name

KIMBERLEY M JOHNSON DC

Practice address

12814 Lake Boulevard
Lindstrom, MN 55045

Phone

(651) 257-3900

Fax

(651) 257-3932

NPI assigned

Nov 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kimberley M Johnson, DC

Title

Chiropractor Owner

Phone

(651) 257-3900

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberley M Mintell, DC

  • Chiropractor
  • White Bear Lake, MN
  • NPI 1558542530
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1366516767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 567",
            "address_2": "12814 LAKE BLVD",
            "city": "LINDSTROM",
            "state": "MN",
            "postal_code": "550450567",
            "telephone_number": "651-257-3900",
            "fax_number": "651-257-3932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12814 LAKE BOULEVARD",
            "city": "LINDSTROM",
            "state": "MN",
            "postal_code": "55045",
            "telephone_number": "651-257-3900",
            "fax_number": "651-257-3932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLEY M JOHNSON DC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIROPRACTOR OWNER",
        "authorized_official_telephone_number": "651-257-3900",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA",
            "identifier": "183022800",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02B15LA PIN 02B16J0",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawna Jo Griffin, FNP
• Kelly Marie Helland, LICSW
• Regina Hollibush, LCSW
• Michael A Hursh, DDS
• Virginia Johnson, RPT
• Varghese Daniel Kottarathil
• Lake and Leaf Chiropractic PLLC
• Lake Optometric Vision PA
• Lakes Area Chiropractic Clinic LLC
• Lindstrom Chiropractic Center, P.a.

• All providers in Lindstrom, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.